Rationale:Acute focal bacterial nephritis (AFBN) has mainly been reported in pediatrics. It may be an underdiagnosed condition in adults because it resembles acute pyelonephritis (APN) in its clinical presentation.Presenting concerns of the patients:Two young women (25 and 27 years old, respectively) presented with complaints compatible with a diagnosis of APN. However in both, fever was of high grade, persistent for several days in spite of antibiotic administration, and there was demonstrated worsening of the inflammatory biomarkers. A contrast-enhanced computed tomography (CECT) led to the diagnosis in both cases.Diagnoses:Contrast-enhanced computed tomography reveals the most sensitive and specific images of AFBN. This includes wedge-shaped lesions with decreased enhancement, which may be focal or multifocal.Interventions (including prevention and lifestyle):Antibiotic therapy for at least 3 weeks.Outcomes:Resolution of AFBN was obtained after 3 weeks of antibiotics.Lessons learned:Our 2 cases illustrate the importance of CECT imaging to confirm the diagnosis of AFBN. Interstitial bacterial inflammation may have a worse prognosis if not diagnosed early and efficiently treated. Unlike APN, the management of AFBN requires at least 3 weeks of antibiotics to prevent the development of renal scarring and renal abscess.
The conservation of energy and the improvement in lifetime of the network has been a challenging task in Mobile Ad hoc Networks (MANET) due to their dynamic and unpredictable behavior and topology change. A route selection and packet drop due to limited buffer(queue) size are two important factor that causes energy consumption by handling retransmission of dropped packets. So many energy aware routing and queue management strategies have been introduced individually. By combining energy based routing with queue management, the lifetime of the network can be increased most effectively. This paper proposes integrated maximum energy based routing with prediction of the route failure by energy estimation and Dynamic queue initialization to reduce packet drop. We modified AODV protocol and drop-tail queue. A Simulation has been performed on NS-2 with the parameter packet delivery fraction, Throughput, endto end delay and number of packets. By comparison planned approach with the old one better result has obtained.
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